education

NeuroDoC: Students Build AI Chatbot to Support Care of Coma Patients

Students in Jacey Greece’s strategic interventions course partnered with an alum and her team at Mass General Brigham to strategize ways to help MGB physicians follow the most up-to-date guidance in managing patients with disorders of consciousness (DoC), a group of conditions involving alterations to wakefulness and awareness such as coma.

Search “AI for healthcare” online today and an avalanche of articles result—many focused on the dangers of soliciting medical advice from AI-powered chatbots.

Recent research has shown that bots may provide inaccurate and inconsistent information to patients, putting them at risk of misdiagnosis and mistreatment. But what if instead of sidelining clinicians, AI were harnessed to support them?

Tools such as OpenEvidence currently help physicians synthesize medical literature and apply diagnostic guidelines at the point of care, enhancing clinical decision making in real time. Building on this idea, a team of MPH students at the School of Public Health created NeuroDoC, an AI chatbot designed to help clinicians follow current guidance for managing disorders of consciousness (DoC)—a group of conditions resulting from severe brain injury that cause alterations to wakefulness and awareness including coma, vegetative state, and minimally conscious state

NeuroDoC was developed during the fall 2025 offering of Designing Strategic Interventions and Communications to Advance Public Health (SB806), taught by Jacey Greece, clinical professor of community health sciences. Through practice-based teaching, Greece pairs students with working professionals to consult on real-world public health problems such as the dissemination of clinical practice guidance.

“I designed SB806 to encompass all three aspects of the school’s mission: Think. Teach. Do. For the Health of All,” says Greece. “The students’ chatbot is a perfect example of the innovation that can come from an environment where Think. Teach. Do. converge. There’s no question about the benefit of AI in this particular situation.”

While doctors have a professional responsibility to stay current with best clinical practices, evidence- and consensus-based practice guidelines have increased in number and complexity over time, limiting their uptake and use. Studies show that only half of guideline-recommended treatments are implemented appropriately in routine practice, suggesting doctors need support accessing and applying guidance.

Joseph Giacino, director of rehabilitation neuropsychology at Spaulding Rehabilitation Hospital and a professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School, has experienced this problem firsthand. He was part of the task force that developed and published clinical management guidelines for patients with prolonged DoC. But those 2018 DoC guidelines total more than 200 pages, and whether providers are consulting them consistently is an open question, Giacino says.

“This is an area fraught with misunderstanding, confusion, and nihilism. About four in 10 persons judged to be unconscious on bedside examination actually retain conscious awareness,” says Giacino in a video explaining the Disorders of Consciousness Practice Guideline Knowledge Translation Project, a study he is leading to evaluate providers’ awareness, beliefs, and adoption of the 2018 guidelines. “Prognostication is often inaccurate and life-sustaining treatment may be prematurely withdrawn.”

In September 2025, Giacino and his team from Spaulding’s Neurorehabilitation Laboratory brought this challenge to Greece’s SB806 class. Over the course of the 14-week semester, the students worked to devise practical ways to support clinicians caring for patients with DoC across the Mass General Brigham (MGB) system.

“Our task was to bridge the gap between evidence and practice,” says Olivia Glass, one of the four SB806 students who conceived and developed NeuroDoC. Glass and her teammates Remy Mosaheb, Favour Ofuokwu, and Emily Reed had no prior knowledge of DoC, Glass says, but after meeting regularly with the Neurorehabilitation Laboratory team, interviewing MGB clinicians, and reviewing the literature, they were able to identify gaps in practice and pinpoint where the providers have experienced the most uncertainty.

“We started brainstorming ideas to quickly deliver information to clinicians. We know they are busy and don’t have time to sit down and read all the guidelines in depth during their workday,” Glass says. “[Mosaheb] and I had built a chatbot the semester prior and thought it would be an innovative way for clinicians to ensure their care plans aligned with the guidelines.”

Drawing on technical skills Glass and Mosaheb gained in Using Mobile Technologies to Improve Health Outcomes (GH806) the previous semester, the team used Dimagi’s open-source platform Open Chat Studio to design and build NeuroDoC in roughly two weeks.

They presented their final proposal to Giacino and his team in December. The intervention, titled the “Clarity and Consciousness Initiative,” included the NeuroDoC chatbot, an educational video series with sample patient-caregiver narratives, and an updated web platform with additional resources such as interactive simulations for providers to role-play use of the 2018 guidelines.

“I’ve never been prouder of a project I’ve worked on,” says Glass, now a second-year student studying health communication and promotion and health policy and law. “I hope that NeuroDoC equips providers with the confidence to use evidence-based practices to provide high-quality care and reinforces behavior change, not just at MGB but across the states, because these patients should have the chance at recovery.”